Iowa, Mass. Lead U.S. in Children's Health Care

Top 5 States for Healthy Kids continued...

In general, the states that ranked at the top scored high on multiple indicators, she says. They tended to take proactive steps to cover children or families and promote public health.

By contrast, states that did not receive top marks tended to have less coherent public policies and were less transparent, meaning they were less likely to gather and share information on how one community compares to another in terms of health care initiatives.

“We can do better,” says Edward Schor, MD, vice president of the Commonwealth Fund. “What is unique about this scorecard is that it looks at what has been achieved by the top states and holds that performance up as an example for other states. If it’s possible to insure almost all kids in Alabama, it should be possible in Texas and Mississippi.”

Alabama stood out among other Southern states for its high rates of insured children, the report showed.

CHIP: Another Viewpoint

Not everyone agrees with some of the report card’s conclusions.

“This is very far from an even-handed look at the state of child health and it is being used this to drive a policy agenda,” says Michael Cannon, director of health policy studies at the Cato Institute, a nonprofit libertarian think tank based in Washington, D.C.

It is not the state rankings that he takes issue with, but the fact that the group is using them to make a case for CHIP and other federal government health care policies, he says. “CHIP is cost-inefficient because it crowds out private insurance and makes people depend on government coverage,” he says. In addition, “CHIP subsidies disappear when you increase your earnings, so many people fall into a low-wage trap.”